Archive for October, 2009

October 31, 2009

permanence

It’s autumn. The leaves have begun to change color, and some have already fallen to the pavement. You can see the leaves just flying away, carried by the breeze.  I usually love just watching these colors, but this year, the change in season has been coupled with some dreary days. I can’t remember the last time there was blue sky. Anyway, the auburn hues will in the coming weeks  all turn to the color of the earth and find themselves on the ground, as if they were returning back to the soil that brought them up. They teach me that there is no permanence in life. That’s the only thing that doesn’t change.

I found out that my freshman roommate’s mother had passed away. It wasn’t sudden, but from cancer that she, just this spring, found out had already ravaged her whole body. My roommate Katherine had kept a blog chronicling this journey until her mother’s death. I could not stop crying as I read those words, so beautifully written. Perhaps it had to do with the fact that my own mother was diagnosed with cancer two years ago (she’s currently doing fine). Sure, it did hit close to home, but my tears were more than about that. In reading Katherine’s blog I saw a sense of strength despite what must be a difficult time. I found that inner strength so beautiful, but I was so sad that it was in this time that I recognized that part about Katherine. I think a part of me wished I could be more like her.

I look outside and see the trees. I think about Katherine. Though I cannot imagine the pain, it’s clear to me that Katherine will be fine.

Then I notice that those trees were now against a brilliant blue background.

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October 31, 2009

Senators announce the “ENHANCED Act”! Read all about it!

This is great! See below. Thank you, Senators!

Stabenow, Voinovich, Brown, Kerry Announce Bi-Partisan Legislation to Help Treat Americans Suffering from Depression and Bipolar Disorders

WASHINGTON – Today, U.S. Senators Debbie Stabenow (D-MI), George Voinovich (R-OH), Sherrod Brown (D-OH), and John Kerry (D-MA) announced the bi-partisan “ENHANCED Act” to establish national centers of excellence for the treatment of depression and bipolar disorders. These centers will create a national network to help diagnose people in need and improve access to evidence-based, quality care. Senator Kay Bailey Hutchison (R-TX) is also a co-sponsor.

“Depression and bipolar disorders affect one of every five people in the United States. Unfortunately, nearly half of all diagnoses are missed,” said Senator Stabenow. “This legislation will provide direct federal support to better treat people with depression and bipolar disorders. It will save lives and improve the quality of life for millions of Americans.”

“I am happy to co-sponsor the Enhanced Act with my colleague, Senator Stabenow,” Senator George V. Voinovich said. “This legislation will bring attention and better coordination of research and treatment for depression and bipolar disorders – to improve the quality of life for our constituents.”

“Barriers to treatment pose an additional challenge for Americans suffering from depression,” said Senator Brown. “By building off the important work by Ohio’s University of Cincinnati, Lindner Center of HOPE, and other premier research institutions, this legislation would establish the first nationwide network of health centers specializing in treatment for depression. For individuals struggling with depressive and bipolar disorders, these treatment centers can offer more options and new hope.”

“When government fails to support research and treatment, it stigmatizes depression and takes us backwards to a time when those suffering with depression were told to stay silent,” said Senator Kerry.  “I’m grateful for the work doctors and researchers are doing every day to provide early, effective treatment for depressive disorders and I’m honored to partner with Senator Stabenow to get them the support they deserve.”

More Americans suffer from depression, bipolar illness and other mood disorders than from coronary heart disease and cancer combined. With medication, psychotherapy, or combined treatment, most people with these disorders can be effectively treated and resume productive lives. Yet one-third of those suffering from depression—nearly five million Americans—do not receive treatment because they cannot afford it, don’t know where to go, or are afraid of societal judgment. Depression also has a significant economic impact, estimated to cost the United States over $83 billion annually due to reduced productivity, absenteeism, and mortality.

This legislation is based on efforts catalyzed by the University of Michigan Depression Center with 15 other leading academic medical centers across the nation. Joining together, these universities created a network of depression centers positioned to take academic research and translate it into practice, standardize diagnoses, treat early and more effectively, and prevent recurrences of depression and bipolar disorders.

The ENHANCED Act of 2009:
•  Creates a national network with a pathway for developing and expanding up to 30 depression centers of excellence to increase access to the most appropriate and evidence-based depression care.

•  Develops evidence-based treatment standards, clinical guidelines, and protocols to improve accurate and timely diagnosis of depression and bipolar disorders.

•  Expands multidisciplinary, translational, and patient-oriented research by fostering the collaboration of academic and community-based service centers.

•  Establishes a sustainable national resource for public and professional education and training, to advance knowledge and eradicate the stigma associated with depression and mood disorders.

 

 

October 29, 2009

How College Can Unleash Mania/Depression: Health.com

This article is concise, informative and to the point. I personally thought this was one of the better articles I’ve read on bipolar disorder and mental health on campus.

Health.com: Back to Sc hool with Bipolar? How College Can Unleash Mania

The rituals of college—making new friends, studying until dawn, excessive partying—can stress out any young adult. But students with bipolar disorder, or those at risk for the condition, are even more vulnerable in a college environment. Academic pressures, social concerns, and sleep disruptions can lead to bouts of depression as well as mania, the euphoric, revved-up state characteristic of bipolar disorder. Without the right treatment and support, bipolar college students face higher dropout rates, drug and alcohol abuse, and even suicide.

The article cited Russell Federman, PhD, the director of Counseling and Psychological Services at the University of Virginia student health center. He has a forthcoming book, Facing Bipolar: The Young Adult’s Guide to Dealing With Bipolar Disorder.  He writes about the “four S’s of bipolar stability”: structure, stress management, sleep management, and self-monitoring. This framework entails setting—and sticking to—a regular schedule of studying and sleep, and learning to recognize the signs that you are beginning to drift into mania or hypomania.  I needed to be reminded of that structure, so I thought these “S”s were rather helpful.

 

October 27, 2009

Antipsychotic Drugs Cause Rapid Weight Gain in Children

In case we didn’t already know, a new study shows that antipsychotic drugs widely used in children caused youths to gain as much as 19 pounds on average after just 11 weeks on the medications, according to a new study published in the Journal of the American Medical Association. (Wall Street Journal)

Thanks for pointing out what adults have been experiencing for a while now, American Medical Association. When I was first prescribed Depakote (which was not part of the study), I gained 30 pounds within 2 months or so. Though the article makes it sound as though weight gain is an issue only when children take this medicine, but weight gain should be a concern among adults as well. We already have one illness to deal with. We don’t need to add a weight problem on top of it.

NY Times news coverage
Reuters

October 27, 2009

Concerning Concerta

An unfinished paper stares at me in the face, but I can’t seem to get it done. All I need to do is read what I’ve already written and revise it. That’s all. But I very well know my limit of attention span, and I’ve reached my limit. I don’t really have any left to give. I can’t focus. Of course, I love that while I can’t accomplish what I need to be doing, I have enough concentration to write a journal post…

I take Concerta in the morning so that I don’t choose to go hide in bed during the day. Concerta is a psychostimulant indicated in the treatment of attention deficit hyperactivity disorder, but it was not prescribed to me for an issue with concentration (off-label uses do include depression). But I do know that people do take these to help them with those problems. I have a handful of Concerta left in my medicine stock. Should I take one now to get me through for an extra few hours tonight? I know I shouldn’t do something like this; this is technically abuse.

Here’s the added dilemma. In the past, I’ve stayed up late at night to study, but I know it’s critical that I keep my sleep cycle consistent (lack of sleep quite often leads to cycling or hypomania). By taking Concerta I would be allowing myself to stay up later and thus screw up my sleep schedule. I’ve known that I have bipolar disorder for a few years now and that it’s really not a good idea for me to get to bed at 2am. I’ve also known about this exam for two weeks. By this point, I should know to space out my studying to accommodate my illness.

So, here I am at my dining table with my study materials sprawled out, facing the reality that I’ve placed myself in. This is such a dumb move on my part. Time ticks away as I still ponder, should I take that Concerta? Now I’m just wasting time thinking about this while I keep losing little time I have left to work on this paper.

October 26, 2009

Combating the Stigma of Psychological Injuries – NYTimes.com

Combating the Stigma of Psychological Injuries – At War Blog – NYTimes.com.

October 26, 2009

A Push for Colleges to Prioritize Mental Health: NPR

Last week, Morning Edition on NPR had a story about mental health on college campuses. A friend called to tell me that NPR had another story in this series: A Push for Colleges to Prioritize Mental Health. This story certainly adds to the first coverage.

I should be working on some take-home exams, so I’ll refrain from commenting on this piece for now.

October 25, 2009

Colleges See Rise in Mental Health Issues: NPR

On Morning Edition/NPR this past week, they had a story: Colleges See Rise in Mental Health Issues.

“They may not tell their roommates or even close friends, but on college campuses all across the United States, more students than ever before are seeking psychiatric help, according to recent national surveys of campus therapists.”

This story is close to my heart, so I was so glad to see that this issue was getting some coverage. I think the rise in numbers of student seeking help may actually reflect well on the college mental-health system. It could very well mean that more students feel comfortable enough to see a professional. After all, as a full-time college student, one is eligible to receive some free (at least from what I know) mental health care. It was the spring semester of my junior year when I first sought the help of the student health center’s staff psychiatrist.  It still wasn’t easy to seek help, but I am so glad this system was available to me. Had there not been such service available in this way, I would have never found a way to receive anyone’s help.

The increase in the use of college mental-health facilities should not be of such great concern (of course, it should always be of some concern). First, the average age of onset for many psychiatric conditions matches the age group of most college students. Second, being in college is probably the first time anyone has such open access to mental health services where they themselves can determine whether to seek help (not many kids would easily be able to ask their parents to take them to a psychiatrist). If anything, these findings should encourage the schools to further assess their plan in handling the larger caseloads as well as treating the students more effectively.

October 24, 2009

Newsweek on Men and Depression

NEWSWEEK has done an amazing job in covering the topic of  men and depression. Most of these articles/videos/etc. were published two years ago, but they are well worth checking out.

Men & Depression: Facing Darkness
“Six million American men will be diagnosed with depression this year. But millions more suffer silently, unaware that their problem has a name or unwilling to seek treatment…Although depression is emotionally crippling and has numerous medical implications—some of them deadly—many men fail to recognize the symptoms. Instead of talking about their feelings, men may mask them with alcohol, drug abuse, gambling, anger or by becoming workaholics. And even when they do realize they have a problem, men often view asking for help as an admission of weakness, a betrayal of their male identities.”

Mind Of A Man: Stop Pretending Nothing’s Wrong
It’s Hard For Men To Admit Or Even Recognize Their Own Depression. How To Get Help

Video: Men & Depression: The Silent Scourge

Understanding Male Post-Partum Depression
An expert on why fathers can also become depressed after the birth of a child, and what couples can do about it.

Video: Depressed Men

They also have a link that lists some depression resources.

October 24, 2009

spreading BringChange2Mind.org

“The World Health Organization (WHO) estimates that by the year 2020 mental illness will be the second leading cause of death and disability. Every society will have to confront the issue. The question is, will we face it with open honesty or silence?”

Above is a quote from Glenn Close’s column in the Huffington Post: Mental Illness: The Stigma of Silence.

Glenn Close is one of the founding members of BringChange2Mind.org, a not-for-profit organization whose mission is to: provide people with misconceptions about mental illness quick and easy access to information that combats stigma, and provide people with mental illness, and those who know them, quick and easy access to information and support. Co-creators include, the Child and Adolescent Bipolar Foundation (CABF), Fountain House, and Garen and Shari Staglin of IMHRO (International Mental Health Research Organization). The campaign has the support of major mental health organizations, including Active Minds, the American Foundation for Suicide Prevention (AFSP), International Mental Health Research Organization (IMHRO), the Jed Foundation, Mental Health America (MHA), National Alliance on Mental Health (NAMI), NARSAD, National Institute of Mental Health (NIMH), and the Substance Abuse and Mental Health Services Administration (SAMHSA).

Their web site, bringchange2mind.org, isn’t just a web page with random facts about mental illness; there are video clips where people share their stories about their lives. You can also share your story by uploading your own video. The one neat aspect of the website is that they tell the reader how to get involved. Some suggest writing to an organization, but it’s as simple as watching our language.

October 23, 2009

Eli Lilly to Pay South Carolina $45 Million Over Zyprexa

Lilly to Pay South Carolina $45 Million Over Zyprexa (Update2) – Bloomberg.com.
Eli Lilly agreed to pay $45 million to South Carolina in order  to settle a lawsuit claiming the drugmaker improperly marketed its antipsychotic Zyprexa. South Carolina sued Lilly, with allegations that Zyprexa, approved for schizophrenia and bipolar disorder, was marketed for off-label or unapproved purposes. The state initially sought for up to $6 billion in fines and damages.

October 23, 2009

Rapid-Cycling Bipolar Disorder

Maybe this doesn’t change anything. It’s kind of interesting, I suppose. I mean, after all, it is just a diagnosis, or ‘diag-nonsense’ as Lisa in ‘girl, interrupted’ calls it. Well, it’s a subtype of a diagnosis which I already knew I had.

I have been very compliant in taking my medication for months now. I don’t remember the last time I intentionally missed a dose of my chemical cocktail. For some reason the other day, I pondered why I was taking all of these pills. What would happen if I just stopped? Would anything change? Would I encounter the real me (and what would that be)? I shared these thoughts with my psychiatrist, Dr. A. She asked me if these thoughts came from whether I wanted to see if I can be maintained with just ECT. Actually, that’s really not an issue with me. In fact, I’ve tended to view the two treatments as separate entities, though they really can’t be separated. Dr. A warned me that if I did choose to discontinue medication that I do it gradually, for I would likely face horrific consequences should I abruptly stop all meds.

We then began talking a little bit about the number of pills I took during the day. As the conversation went on, she said something about how for “rapid-cycling bipolars, the average number of medications is five.” Five is a rather large number of meds, I thought,  but what’s this about rapid-cycling bipolar?

Apparently, I have rapid-cycling bipolar disorder.

And what is rapid-cycling bipolar disorder?
A great summary about rapid-cycling bipolar disorder is found on MedScape’s Continuing Medical Education site. (just noticed you might have to go through their free registration system to access this article)

And according to WebMD: Rapid cycling is a pattern of symptoms in bipolar disorder. In rapid cycling, a person with bipolar disorder experiences four or more episodes of mania or depression in one year. About 10% to 20% of people with bipolar disorder have rapid cycling, and people with bipolar II disorder are more likely to experience rapid cycling. Nearly everyone with bipolar II disorder develops it before age 50. Rapid cycling bipolar disorder can be difficult to diagnose. Rapid cycling may seem to make bipolar disorder more obvious, but because most people with rapid cycling bipolar disorder spend far more time depressed than manic or hypomanic, they are often misdiagnosed with “just” depression. For example, in one study of people with bipolar II disorder, the amount of time spent depressed was more than 35 times the amount of time spent hypomanic. Also, people often don’t take note of their own hypomanic symptoms, mistaking them for a period of unusually good mood.

Well, I do fit the bill for this type of bipolar, according to the description from WebMD. I guess it’s good that I know this information, since this only helps me in understanding my illness better.

And as for quitting my meds…. I am looking at two take-home exams in front of me as I type this entry. I think I better stick with the routine at least until I get done with these exams. I’ve made the mistake of my school work (and the rest of life) suffering as a result of noncompliance. This just isn’t the time to make that mistake again. I remind myself: I’m getting another shot at putting my life back together, and I need to take responsibility for what I know I can control –which includes popping a few pills every day.

October 22, 2009

‘is your cat depressed?’

sadcat

last night at the vet

I had to take my cat Simon back to the vet (the emergency clinic, to be exact) last night because he hadn’t urinated all day and began to vocalize some sort of pain. Because the emergency clinic is in the same location as the daytime place where he had the surgery, the nighttime staff already knew Simon –and Simon already knew them. As soon as we sat down to wait our turn, he decided to pee in the carrier. Though that may be upsetting to some, I was actually relieved since the type of surgery he had was to allow him to urinate on his own again.

Though his main issue was resolved in the carrier, we saw the veterinarian anyway. As she checked on him, she asked me, “Does he seem depressed to you?” I burst out a bit of a laughter, not necessarily because I found the question to be funny. I immediately thought to myself, could I have infected my cat with my illness?, and am I not the only one who’s depressed in this house? I’m sure the vet had no clue why I would start chuckling over a serious question about my cat’s health. She obviously wouldn’t know what that question means to me, and I just never thought that question would be asked in regards to someone else other than myself. I composed myself and told her that I didn’t think the cat was depressed. He got some anti-inflammatory meds and fluids injected in him, and we went back home.

In case anyone wondered, here’s a ‘cat depression checklist.‘ Also, Purina has a short article on how to help a depressed cat. Among other things, one option is to feed it antidepressants.

It would be really strange if my cat and I started sharing the same prescription…

October 22, 2009

Study: Light At Night Linked To Symptoms Of Depression In Mice

Researchers from Ohio State University found that mice housed in a lighted room 24 hours a day exhibited more depressive symptoms than did similar mice that had a normal light-dark cycle.

October 20, 2009

In praise of ‘electroshock’ – The Globe and Mail

In Saturday’s The Globe and Mail, there’s an article: In praise of ‘electroshock’. I think it’s a very straightforward article on ECT. Most news pieces aren’t so blunt about actually being so positive about ECT; many usually have that ambivalent tone to them.

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